HHS finalizes Medicaid rule

By BenefitsPro

Health reform authorizes states to expand Medicaid to adult Americans under age 65 with income of up to 133 percent of the federal poverty level—about $15,000 for a single adult in 2012—and provides unprecedented federal funding for these states.

Under the new regulations, the federal government will pay all of the cost of certain newly eligible adult Medicaid beneficiaries through 2016, phasing down to a permanent 90 percent matching rate by 2020. It will remain there permanently.

The rule, issued by the U.S. Department of Health and Human Services, will take effect in January of next year.

“This is a great deal for states and great news for Americans,” HHS Secretary Kathleen Sebelius said. “Thanks to the Affordable Care Act, more Americans will have access to health coverage and the federal government will cover a vast majority of the cost. Treating people who don’t have insurance coverage raises health care costs for hospitals, people with insurance, and state budgets.”

HHS said the rule builds on several years of work that the department has done to support and provide flexibility to states’ Medicaid programs ahead of the 2014 expansion. The rule also offers more collaboration with states on audits that track down fraud and outlines ways states can make Medicaid improvements without going through a waiver process, HHS said in comments.

The administration will take comments from interested parties and the public for 60 days. The full text of the rule can be found here.